Causes of teenage pregnancy in south africa pdf

Therefore, understanding the association between teenage pregnancy and various social and economic factors would help reduce teenage pregnancy rate in Africa. Methods: Data sets from the World Bank Organisation of all Africa countries between and were obtained to conduct this study. The trends of average teenage pregnancy rate across all regions were examined using descriptive method.

Also, the association between teenage pregnancy rate and various economic and social factors were investigated using multivariate statistics methods. Results: In all 52 countries examined there has been a significant reduction in the African teenage pregnancy rate between and In addition, correlation analysis carried out showed an inverse significant relationship with life expectancy, literacy rate and contraceptive prevalence.

Further analysis reveals that female literacy rate is the most important predictor of teenage pregnancy in Africa. Conclusion: The findings of this research indicate that social and economic factors are important predictors of teenage pregnancy rate in Africa. Evidence from this study suggests that a practical approach to reducing the current teenage pregnancy rate is to develop strategies and policies that support and promotes female literacy.

Keywords: Teenage pregnancy, Africa, social and economic factors, determinants, trend. University of Wolverhampton, United Kingdom. Teenage pregnancy has been defined by stating that the average teenage pregnancy rate in the World Health Organisation WHO as developed countries was 29 births per ; pregnancy in females aged 19 years.

According whereas, in developing countries teenage pregnancy to WHO report, an equivalent of 16 million rate was as high as births per females. This view is influences teenage pregnancy rate in Africa. This is the economy, hence, impeding the economic and because teenage parents often become deprived social progress of such nations. Furthermore, pregnancy rate in Africa, there is a need to research Lemos highlighted that low educational the determinants of teenage pregnancies in Africa.

Were have identified factors such as poor use of contraceptives in Morocco and low educational Family and cultural norms such as early marriage in attainment in Kenya respectively. Although, Westoff, Blanc to the Africa continent. This study adds to current and Nyblade highlighted that the age of knowledge in the research community by thoroughly female at marriage is subsequently increasing in examining the determinants of teenage pregnancy in Sub-Saharan Africa, however, the World Bank Africa.

Synopsis makes clear the pace is quite slow. In addition, Dev Raj et al. The determinants of teenage pregnancy in rightly points out those adolescent girls rarely developing countries have been identified as majorly take part in decision making. Data sets utilised in this study have been obtained from the World Bank Organisation freely within the public domain.

In addition, these data sets do not contain any information that can breech confidentiality of the participants' countries. Therefore, there are no ethical issues to be considered for this study as it Figure 1: Conceptual Framework poses no harm.

African nations that account for differences in their The Independent variables are: teenage pregnancy rates. This ranges pregnancy will most likely be countries with better: from , with zero and signifying perfect education; employment opportunities for women; equality and inequality respectively.

Moreover, this simple statements. World Bank Group, The Africa percentage of the population aged 15 and older continent is made up of 54 countries which are sub- that is economically active by engaging in the divided into 5 regions, these are: North, East, West, production of goods and services.

Southern and Central. It ranges from with 1 signifying low and 6 high. Next, a paired sample t-test was conducted, Correlation Analysis thereafter, data sets from was used to conduct correlations and regressions. Descriptive Analysis The mean teenage pregnancy rate across each region Furthermore, correlation analysis between all from The mean teenage pregnancy rated variables reveals that as GDP per capital increases, across can be seen in Table 1 see appendix 1.

Likewise, increased literacy rate is lowest in Northern Africa. This finding contradicts rate. See results in table 3. In general, most of the previous evidence which indicates that teenage independent variables were in the expected pregnancy remains high in Africa Sedgh et al ; direction, which is inversely associated with teenage World Health Statistics, ; Mangiaterra et al.

Similarly, amongst all continents. The finding from this study is Labour 0. However, this Life 0. This signifies revealed that in countries with low literacy rate, that literacy rate is a significant predictor in the contraceptive prevalence rate and life expectancy, regression model accounting for A possible explanation for this non- complications and childbirth.

Additionally, Dev-Raj significant finding is that health care expenditure makes clear that children born of teenage measures the amount spent by the government on mothers are often unhealthy, as they are more likely the citizenry health and not specifically for women. Moreover, In line with findings from WHO significant relationship between teenage pregnancy and WHO reports, this research found rate and gender equality rate in Africa. This could be that GDP per capita has a positive association with due to the fact that the data sets for gender equality contraceptive prevalence rate.

In essence, this was not specific for women rather it represented research has demonstrated that in countries with both women and men equal access to education, high GDP per capita, there is good access to healthcare services, the economy, and protection contraceptive services and better use of such under law were measured. Contrary to previous assumption made by This study also found a positive relationship Isaranurug, Mo-suwan and Choprapawon as between GDP per capita and literacy rate.

Furthermore, the finding from this study also reveals that there is an inverse Also, this study demonstrates that countries with relationship between the life expectancy rate and high literacy rate would have high contraceptive labour participation rate of females in Africa.

Thus, prevalence rate. This supports Martin notion as female labour participation increases, life that education equips women with the knowledge to expectancy decreases.

Besides, actions that can help improve contraceptive This contradicts previous assumptions which prevalence such as sex and relationship education indicate that an increase labour participation rate are inadequate in developing countries WHO, will increase life expectancy given that females in Perhaps, this disparity In contrast with Gold et al study there was no is due to the female labour participation rate significant relationship found between GDP per indirectly referring to women who are not full-time capita and teenage pregnancy rate.

A possible housewives but involved in some sort of explanation for this non-significant result is in unstructured or low paid employment or work that accordance with findings from the World Bank exposes women or girls to hazard such as synopsis which indicates that changes in agricultural hazards. Besides, the data sets did not teenage pregnancy rate cannot easily explain provide information on the kind of employment the changes in GDP per capita, although, high GDP per women were engaged in.

Abdsselam, B. African Journal of that indicate that low educational attainment appears Reproductive Health.

Thus, a focus on Factor. The American, 2 6 , pp. Journal of nursing scholarship. Despite these limitations, this study has [online]. World Bank. It is a large population- ]. In addition, this section of countries. It provides useful information towards understanding the magnitude of teenage pregnancy among the South African youth and helps determining areas that require serious intervention efforts in order to reduce the rates of teenage pregnancy.

Understanding the factors or determinants associated with teenage pregnancy is crucial because it is this understanding that will enable development of intervention programmes needed to address teenage pregnancy in the country. Thus, the aim of this particular study is to examine the trends in teenage pregnancy as well as related health risk behaviors, including unsafe sex, substance use, partner violence, and psychological well-being; which might act as contributory factors associated with teenage pregnancy among school-going adolescents between 11 and 19 years of age in different settings of the country.

Three cross-sectional surveys were conducted among nationally representative samples of grades 8 to 11 secondary school adolescents in South Africa in , , and For each sample the most recent list of all public schools in the country, provided by the South African National Department of Education, was used as the sampling frame, to ensure nationally representative data.

In each survey twenty-three schools per province were sampled and invited to participate. At the second stage of sampling, classes were randomly selected within each participating school. A total of 14 for survey , 13 for the survey and 14 for the survey enrolled adolescents from grades 8—11 in the participating schools per province were invited for each survey respectively.

Adolescents completed a self-administered questionnaire on a range of socio-demographic characteristics and risk behaviour variables. The measures used in the study are specified below. Age: to determine the ages of adolescents in the sample, adolescents were asked to report both their age and date of birth.

The number of lifetime sexual partners therefore, refers to the number of sexual partners one has ever had sexual intercourse with in their lifetime. Binge drinking in the past month: Adolescents were categorised as having engaged in binge drinking if they reported having had five or more drinks of alcohol e.

It was used to reduce anxiety and tension when it was legal as a sedative and hypnotic drug. Due to its addictive nature, it is now illegal for medical use and commonly used by recreational drug users [ 34 ]. Mandrax is amongst the frequently abused drugs used by drug users in SA, hence its inclusion in this study. Active informed consent to conduct the study was obtained from the National Department of Education, school principals, parents and learners. In addition, assent was also obtained from learners on the day of the study.

Learners were requested not to write their names on the answer sheet to ensure their anonymity. School teachers were requested to leave the classroom during data collection time.

Learners were also requested not communicate with each other or look at the answer sheet of their peers during the completion of the survey. Information sheet regarding the surveys was also provided to the learners.

Frequency data were weighted to approximate province level distributions of gender and grade, and to account for non-response and province size. Weights were post-stratified by grade and gender, so that the weighted counts of students in each grade and gender combination were in proportion to the provincial population proportions.

Each province was to be represented equally in the sample. The three different YRBS data sets were combined for the trend analysis purposes. Descriptive statistics were first explored to gain a clearer picture of the data as well as to summarize the characteristics of the overall sample.

The combined dataset was then split according to the respective years. Frequencies were run for each survey to provide overview differences in characteristics for the three surveys. This provided insight into trends in teenage pregnancy and sexual activity behaviours among adolescent who reported to have ever had sex in the three different surveys. Bivariate correlation analysis was performed to establish risky behaviours associated with teenage pregnancy.

A binary logistic regression analysis was used to examine unique associations between the demographic, substance use, violence, and sexual and suicide related behaviour variables, and the primary outcome measure: ever been pregnant.

Collinearity statistics showed the variables taken into the logistic regression model did not violate the multi-collinearity assumptions: all the variables in the model were below the cut off value for the variance inflation factor VIF of 10 [ 36 , 37 ]. The adjusted relationships of these measures for ever been pregnant were modelled in a binary logistic regression model.

A total of 31 school-going adolescents were surveyed during the three surveys , , and The combined sample consisted of Less than half of the adolescents have a father There has been a decrease in sexual intercourse between the adolescents surveyed in , , and those surveyed in Table 1 shows descriptive characteristics of boys and girls, by year and for the combined sample.

There are notable differences on ever had sex between boys and girls throughout the survey years. Sex among boys and girls in the study continued to decrease from In the combined sample similar proportions of both boys Overall, About During the three survey years, 9. In the combined sample, 9. Ever smoked cigarettes was reported by Smoking dagga marijuana was reported by Mandrax, cocaine and other drugs were the least used drugs by the adolescents at 6.

When comparing the different years, marijuana use decreased from The use of mandrax increased in to 8. This pattern was also observed for the use of cocaine in , and at 5. Substance use between boys and girls were notably different. Nearly twenty nine per cent of boys More boys Similarly with binge drinking during the past month, When comparing the three surveys, there is a slight decrease in alcohol use from The overall use of alcohol in the combined sample is The percentage of binge drinkers was The overall percentage of binge drinking in the combined sample was Marijuana, the drug most commonly used by the adolescents in this study was reported by Sniffed glue While girls reported to have ever sniffed glue 7.

Table 2 below shows trends in sexual risk behaviours and teenage pregnancy among girls who reported to have ever had sex.

The prevalence of ever been pregnant among the adolescent girls who ever had sex had increased from The overall prevalence rate of ever been pregnant among the adolescent girls who reported to ever had sex was Among those who reported ever had sex, 8.

Sex with one person was reported by When comparing the three surveys, Having sex under the influence of alcohol was reported by 6. The overall rate was This shows an increasing pattern of sexual intercourse under the influence of alcohol, as well as the use of alcohol. The prevalence of abortion was reported by 5. The overall rate of condom use during sex was reported by Furthermore, condom use increased from With regard to contraceptive methods used, condoms were among the most frequently used method compared to any other methods used at When comparing the surveys, Use of birth control pills, on the one hand were reported by 4.

The overall use of birth control pills in the combined sample was 4. On the other hand, injection use was reported by The overall use of injection was In the combined sample, The associations between the teenage pregnancy and risky behaviours were examined for those reported to have ever had sex.

Table 3 below shows the results of the Pearson correlations between teenage pregnancy and the risky behaviours. This negative association, although weak, shows that when teenagers practise protective behaviours such as using condoms during sex; they are less likely to become pregnant. Logistic regression analysis Table 4 showed significant associations between race and teenage pregnancy with being White having lower odds of ever been pregnant OR: 0.

Girls who engaged in first sexual intercourse at the age 13 years or younger had higher odds OR: 1. Having sex with 2 or more sexual partners had higher odds OR: 1. Condom use, as a contraceptive method used to prevent pregnancy had lower odds OR: 0. Girls using injection OR: 1. Among the smoking and substance use related behaviours; smoking cigarettes OR: 0.

Thus, adolescents smoking cigarettes and or using these drugs were more likely to ever been pregnant, than adolescent who were non-users. The first important finding in this study is that sexual intercourse among adolescents has decreased. However, among those adolescent girls who reported to engage in sex, teenage pregnancy has increased. These findings are in line with increasing evidence demonstrating the magnitude of teenage pregnancy among sexually active adolescents, especially in the sub-Saharan African countries [ 1 , 2 , 4 , 19 , 20 ].

This is worrying, particularly the fact that it suggest that there is little progress made in reducing teenage pregnancy over the past few decades, despite its importance as highlighted in the Millennium Development Goals MDG and its association to maternal mortality and morbidity rates [ 5 ]. Teenage pregnancy in developing countries has been reported to be worse than in developed countries [ 4 , 5 ]. The lack of data on teenage pregnancy trends among South African adolescents poses a serious public health threat, as the magnitude of the problem is relatively hidden for consideration into intervention programs that aim to reduce teenage pregnancy, and improve maternal and child health outcomes.

The fluctuating rates of sexual intercourse at the age of 13 years or younger among girls is also concerning. Early sexual debut is not uncommon in SA.

Recent research shows that more and more adolescents are sexually active by the time they are 14 years and older [ 25 , 38 ]. This study shows that the trends in teenage pregnancy have remained steady from to When looking at those girls who reported to ever had sex, teenage pregnancy has even increased from The increased pregnancy rates among these girls can be attributed to, among other factors, the fewer girls who are using contraceptive methods to prevent pregnancy but are sexually active in this study, despite the fact that contraceptives are available for free at the public healthcare settings in the country.

Contraceptives, which are directly provided from the healthcare setting, such as birth control pills and contraceptive injections, are among the least of contraceptive methods used by adolescent girls in this study.

The findings of small proportion of girls using modern contraceptives, such as birth control pills is surprising given the fact that contraceptives are provided free of charge in SA [ 13 — 15 ].

However, this can be explained by 1 the poor knowledge of contraceptives among adolescents in general in SA [ 29 , 38 ], and 2 the limited availability of, and access to sexual and reproductive health services targeted at adolescents [ 39 , 40 ]. Furthermore, the cultural or societal, structural, and individual factors associated with the use of contraceptives are some of the barriers for contraceptive use [ 40 , 41 ].

These include, the need to prove fertility and maturity by the girls, opposition from male partners, perception of personal low risk around the ability to fall pregnant, and fear of side effects [ 12 , 16 , 41 — 43 ]. On one hand, low levels of contraceptive use and the attitude toward using them among adolescents has been associated with high rates of unwanted pregnancies and unsafe abortions among youth in Sub-Saharan Africa [ 40 , 42 ].

On the other hand, low levels of contraceptive use has also been attributed to limited capacity of the health care system, particularly in rural settings and structures within which family planning services are offered [ 6 ]. There is increasing evidence on the youth unfriendliness of the primary health care facilities in the country, which in turn might be a contributing factor to the poor use of contraceptives among adolescents; and thus exacerbate the trends in teenage pregnancy in SA [ 43 — 45 ].

The second important finding in this study is that girls who use condoms when having sexual intercourse were less likely to get pregnant as a teenager. This finding supports previous research on reported knowledge and potential benefits of consistent and correct condom use by most young people in SA [ 43 , 44 ]. It is well known that condom use during sexual intercourse not only prevents unwanted pregnancy; but also prevents contraction of HIV and other STIs [ 43 , 44 ]. This finding also shows that the efforts made by the government in making condoms free of charge and easily accessible are beneficial to the youth of SA [ 9 , 43 , 45 ].

This is also in line with research findings from HICs where decline in teenage pregnancy is attributed to improved contraceptive use, including condom use [ 46 ]. Thirdly, girls who have sex with only one sexual partner in this study were also less likely to fall pregnant compared to the girls who had 2 or more sexual partners during their teenage years. This highlights another important area needing intervention for behaviour change, since a quarter of the girls in this study reported to have sex with 2 or more sexual partners.

The fourth and last finding of this study is the larger proportion of adolescents using alcohol and drugs. Clearly, alcohol and substance use among adolescents also requires attention.

About half of the adolescents in this study have used alcohol one or more times in their lives. Substance use, in a few studies has been linked to teenage pregnancy. A study in Sweden reported that smoking and binge drinking among males was associated with the likelihood of the males having made their partners pregnant [ 49 ]. In this study, girls who never use alcohol before having sex, not practice binge drinking, who do not smoke cigarettes and do not use mandrax were less likely to fall pregnant as a teenager.

The risk factors associated with teenage pregnancy, including alcohol use, smoking tobacco or drug use were also reported by Imamura et al.

The author reported that these health risk behaviours tend to co-occur with teenage pregnancy in the European countries. Some studies have also reported on the possible link between teenage pregnancy and alcohol, and or tobacco and drug use [ 50 — 52 ].

The findings of this particular study show that substance use increases the likelihood of adolescents falling pregnant during their teenage years. This is in line with previous findings that these risk behaviours, especially alcohol use, have been associated with other sexual-risk taking behaviours that result in pregnancy [ 53 ]. This study also found that girls who had a father who is unemployed or deceased were more like to get pregnant; and in terms of race, girls who belonged to the White race were less likely to become pregnant than other races.

This finding supports previous research where low socio-economic status was found to be associated with teenage pregnancy in SA [ 20 , 26 , 27 ]. It is well documented in SA that teenage pregnancy is much more prevalent among the poor Black Africans [ 20 , 26 ]. A limitation of the study at hand is that it is undertaken in the school setting.

This excludes those adolescents who were not schooling at the time of data collection. Teenage pregnancy has been reported to be the most common reason for school-dropout in SA [ 26 , 28 ]. Therefore, some adolescents might be out of school as a result of pregnancy and that does not invalidate the findings of this study, which confirms teenage pregnancy is still prevalent among adolescents in SA.

Another limitation is that the results of this study cannot prove causality of teenage pregnancy by these risk behaviours, but only associations with teenage pregnancy. Thus, future research should aim to mitigate the risk behaviours associated with teenage pregnancy, as reported in this study.

The pattern in teenage pregnancy is clearly increasing among those who engage in sexual activities, and that is a cause for concern. This suggests the further need to address health risk behaviours, including early sexual debut, unsafe sex, substance use and encouraging the correct and consistent use of contraceptives among adolescents; as well as promote their sexual and reproductive health in SA.

Sexual intercourse among adolescents is decreasing, but teenage pregnancy continues to increase among those who are sexually active.

Teenage pregnancy continues to be a growing public health concern and adolescent sexual and reproductive health behaviours, such as contraceptives and safe sex practices has to be acknowledged in the health care system as an important health issue in SA.

Risky behaviours, such as substance use, also need to be recognized and intervention programmes aiming to reduce teenage pregnancy and sexual and reproductive behaviours among adolescents need to include prevention of substance use. This study highlights the need for more comprehensive research on adolescents SRH needs particularly among the vulnerable adolescents aged 16 years and under, but not excluding those aged above 16 years old, to identify risk factors and develop specific interventions tailored for their needs.

Regular monitoring of teenage pregnancy trends and the associated factors also aid in determining the effectiveness of programmes put in place by government and other related institutions, as well as highlighting areas where extra effort is needed to curb the rates of teenage pregnancy. Births: final data for Natl Vital Stat Rep. Google Scholar.

Maternal, newborn, child and adolescent health. Accessed on 14 April Childbearing in adolescents aged 12—15 years in low resource countries: a neglected issue.

New estimates from demographic and household surveys in 42 countries. Acta Obstet Gynecol Scand. Article PubMed Google Scholar. Adolescent first births in East Africa: disaggregating characteristics, trends and determinants. Reprod Health. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study.

Empowering teenagers to prevent pregnancy: lessons from South Africa. Cult Health Sex. Chigona A, Chetty R.